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Cassandra Sanders-Holly DPT ’04

Cassandra Sanders-Holly DPT ’04

Gait Expectations

“They’re sitting backwards; they’re on their hands and knees; they’re standing on the horse. We’re throwing balls back and forth; we’re blowing bubbles; we’re shaking things.”

Cassandra Sanders-Holly DPT ’04 isn’t recounting a Cirque du Soleil spectacle. She’s describing a typical session at Leaps & Bounds Pediatric Therapy, her hippotherapy clinic in Norco, Calif. ( The riders are kids with cerebral palsy, spinal cord injuries, Down syndrome or autism. They ride horses without saddles, stirrups or reins mostly at a walk, but in some cases at a trot or even a lope.

“We have one little boy who drives a motorized wheelchair. He has no independent movement at all. We’ve got 2-year-olds walking with walkers, braces and crutches. It’s pretty powerful to see what these kids can do when they’re up there on the horse,” says Sanders-Holly, an adjunct instructor in USC’s Division of Biokinesiology and Physical Therapy.

Hippotherapy is a treatment that uses the movements of a horse to promote balance and improve gait mechanics. Research shows the biomechanics of a horse’s gait closely mimic those of a human’s walking pattern. Sitting on horseback, the trunk, arms, head and hips experience the same movement as if one were walking.

In a 30-minute hippotherapy session, a rider experiences 2,500 perturbations — unique jolts to which the balance and postural control systems must react. “That’s just impossible to replicate in a clinic,” Sanders-Holly says.

Hippotherapy isn’t new — it’s been around since World War II, when horses were used to rehabilitate wounded veterans. The results are well documented. “It’s the most evidence-based type of treatment in all of pediatric therapy,” Sanders-Holly says. “The demand is huge.” Unfortunately, not many therapists have the wherewithal to offer it. It takes three people to run a hippotherapy session: A skilled handler leads the horse; a therapist walks alongside, working one-on-one with the patient; and a “sidewalker” serves as spotter. The staffing costs pale, however, next to the cost of operating a professional equestrian facility. Still, Sanders-Holly wanted to try. So four years after finishing her doctorate, she decided to leave her pediatric practice in Orange County and return to her hometown of Norco.

Nicknamed Horsetown USA, Norco is zoned for horses, with trails substituting for sidewalks, public stalls in the parking lots, and hitching posts in front of the bank and grocery stores. After Sanders-Holly completed hippotherapy training in 2008, the mayor of Norco introduced her to Sharon Smith, who lives on a private ranch with her daughter, a developmentally disabled adult who rides for pleasure. Smith offered Sanders-Holly full use of her facility — gratis — including all 27 horses, five of which are used in hippotherapy. In less than a year, Sanders-Holly’s hippotherapy practice has grown to 30 patients.

On the days when Sanders-Holly comes to USC to teach courses, she and her husband, Greg Holly ’98, make the two-hour commute together. “It’s a bit of a drive, but it’s my passion,” she says. “I love working with the [doctor of physical therapy] students,” she adds, noting that many drive to Norco to volunteer in hippotherapy sessions. “I’ve got a great life.”


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